Jobsite Safety Evaluation

• Site conducted

  Select

• Safety Kevin Consulting, LLC

  Select 169 Fawn Court Westerville, OH 43081

  • 169 Fawn Court Westerville, OH 43081

• Conducted on:

  Date

• Prepared by

Project:

• Project Name

Job Information

• Location

• Job Number

• Company

• Division

• Type of Roof System:

General Health & Safety

• Are site specific SDS and Safety Program onsite?

  Yes

  No

  N/A

• Required posters displayed on job site?

  Yes

  No

  N/A

• First aid kit on-site and well stocked?

  Yes

  No

  N/A

• Was a quick morning stretch completed?

  Yes

  No

  N/A

• Emergency escape routes & gathering areas designated?

  Yes

  No

  N/A

• Workers trained on hazards specific to the job site?

  Yes

  No

  N/A

• General Photos

  Media

Personal Protective Equipment

• Hard hats required & worn by all workers?

  Yes

  No

  N/A

• Eye and face protection worn when indicated?

  Yes

  No

  N/A

• Hearing protection used when indicated?

  Yes

  No

  N/A

• Proper work clothing worn by employees?

  Yes

  No

  N/A

• Proper footwear worn by employees?

  Yes

  No

  N/A

• Gloves worn when needed?

  Yes

  No

  N/A

• PPE Photos

  Media

Fire Safety

• Fire extinguishers are located nearby?

  Yes

  No

  N/A

• Fire extinguishers are fully charged, with the pin in and the inspection tag filled out?

  Yes

  No

  N/A

• All gasoline stored in safety cans with spark arresters?

  Yes

  No

  N/A

• All compressed gas containers stored upright & outside of building?

  Yes

  No

  N/A

• Is kettle situated at least 20 feet from combustible materials, doors and windows, with an attendant close by?

  Yes

  No

  N/A

• Fire Safety Photos

  Media

Fall Protection

• All leading edges protected by guardrails, warning lines or toe boards as required?

  Yes

  No

  N/A

• Guardrail to rail between 39 & 45 inches off the ground, mid rail 21 inches and cables flagged every 6 ft?

  Yes

  No

  N/A

• Guardrail system installed properly and capable of withstanding 200 lbs of force?

  Yes

  No

  N/A

• Open holes and unprotected skylights covered and marked?

  Yes

  No

  N/A

• Safety harnesses & shock absorbing lanyards used for fall protection on elevations greater than 6 ft?

  Yes

  No

  N/A

• Is the harness adjusted properly?

  Yes

  No

  N/A

• Is the anchor capable of withstanding 5,000 pounds?

  Yes

  No

  N/A

• Is the rope/retractable adjusted properly to prevent falling more than 6 feet?

  Yes

  No

  N/A

• Is the employee working within the required area to prevent swinging more than 6 feet in the event of a fall?

  Yes

  No

  N/A

• Fall Protection Photos

  Media

Access

• A stairway or ladder provided at points of access where there are breaks in elevation of 19 in or greater?

  Yes

  No

  N/A

• Ladders extend 3ft above landing and secured at the top?

  Yes

  No

  N/A

• Straight ladders set at an angle so that base is out approximately 1/4 the working height of the ladder?

  Yes

  No

  N/A

• Workers using ladders properly?

  Yes

  No

  N/A

• All ladders in good working condition?

  Yes

  No

  N/A

• Base is set up on a stable surface?

  Yes

  No

  N/A

• Metal ladders away from energized electrical lines?

  Yes

  No

  N/A

• Stepladders used in an open A frame position?

  Yes

  No

  N/A

• Access Photos

  Media

Hand & Power Tools

• All grinders, saws, etc have guards?

  Yes

  No

  N/A

• All power & hand tools in good working condition?

  Yes

  No

  N/A

• Proper eye & facial protection used for grinding & power actuated tools?

  Yes

  No

  N/A

• All tools being used safety?

  Yes

  No

  N/A

• Hand & Power Tools Photos

  Media

Electrical Safety

• All extension cords & power tools protected by GFCI?

  Yes

  No

  N/A

• All electrical cords in good working condition?

  Yes

  No

  N/A

• All electrical cords placed to protect from future damage?

  Yes

  No

  N/A

• Adequate lighting on job site?

  Yes

  No

  N/A

• Are extension cords daisy-chained together?

  Yes

  No

  N/A

• Electrical Safety Photos

  Media

HAZARDS & CONTROLS:

• Were there any additional hazards on the jobsite?

• Additional Hazard Comments

• Additional Hazard Photos

  Media

• Evaluator Signature:

  Sign

• Foreman Signature:

  Sign